Pharmacy’s crossover moment

What do Julius Caesar, Taylor Swift and community pharmacy all have in common? By Ade Williams

If I ever made it to Mastermind, the two topics I could take on would be Country Music Crossover Artists and Gallic Wars 55BC and 53BC. Chief in my mind from the latter category is Julius Caesar’s famous campaign to secure the Eastern borders, becoming the first Roman Emperor to lead his army across the Rhine.

You may be wondering how this links to pharmacy. Yes, that successful, strategic and operational endeavour enhanced fame and legend, not least before the masterstroke of dismantling the bridges after the expedition. Country music? Be kind to me. I am talking about Taylor Swift-like crossovers.

The recently published Delivery Plan to Recover Access to Primary Care has two goals: firstly, to tackle the 8am rush for GP appointments, and secondly, for patients to know that their request will be managed on a same day basis.

The announcements on expanding community pharmacy services, most notably through Pharmacy First, have been largely well received. This forms one component of NHS England’s ‘empowering patients’ strategy – one of the four pillars of its plan for delivery.

Within the broader context of regulatory changes and announcements, the delivery plan will reshape our profession, practice, and contractual framework. The first challenge is making sure community pharmacies are still around, enthused and empowered to engage successfully. 

Success will also demand sufficient funding, alignment to patient behaviours and desires, forging links with other health and care pathways, plus resoundingly good service delivery design. Our colleagues at Community Pharmacy England have a monumental task, but then so do we all.

In many contexts, the word ‘sustainability’ has rich, expansive connotations around enhancing, advancing and protecting, not merely life preserving. But for community pharmacies, sustainability too often means merely staying alive – a mantra we can never let slip from our minds, and one that is plastered visibly on our premises with ‘Save Our Pharmacies’ posters.

But have we had enough of this existential dread? Psychologists talk about the power of saying no and how this can build self esteem; that genie may have escaped the bottle with the recent decisions around uptake of the NHS contraception service, which saw the sector take a collective stance.

But that collective approach may be under threat. The changes to contractual arrangements for 100-hour pharmacies (now 72-hour pharmacies?) provoked angst among those who operate 40-hour contracts (around 90 per cent of the sector), illustrating the old truth that self- interest is where division finds its roots.

And with the 9 May announcement of its £645 million investment over two years, the Government may soon take licence and claim, ‘as a result of our plans for initiatives launching in winter 2023, we can no longer be blamed for any further community pharmacy closures’.

But these pale in comparison to what I think is the big crossover opportunity, and the bridge building it will require. By that I don’t mean funding; but the massive changes and opportunities in our professional offer in population health management, and our role in driving forward health equity.

We need to take stewardship of this journey. Are the public, patients and fellow healthcare professionals ready for our more expansive professional offer at the local pharmacy? The unhelpful headlines describing new powers to dole out antibiotics have already caused some to take hard lines, which could make the ultimate delivery design more rigid.

So, what are our professional ambitions? The ability to do something new is not always progress in itself. I always argue that when it comes to the relationship between healthcare professionals and patients, what matters is the people who are committing their care to you. You have value only in their trust and the objective outcomes that it produces. What levels of care then are we going to be providing in future? Common ailments are more likely to be self-limiting and not require prescribing interventions.

Underpinned by research and building on their body of work and expertise, other professional colleagues have mapped a progressive journey and built bridges from what they were to what was needed to be their best. 

So, looking for some of the most inspiring ideas submitted for the pharmacy prescribing pathfinder, I wonder what really is the scope of our ambitions? Build bold, build new, build better. We are defining the future models of community pharmacy. As year five of the current contract approaches, the shape of a new contract, with ICB commissioning driving its ambitions, must meet with a bolder, dynamic professional/community pharmacy offer.

This is beyond persons or individuals. How we lead this really matters for it to succeed. A collective professional journey requires broad appeal and consensus. That old chestnut: you would be invincible if you were inseparable. Community pharmacy is critical to delivering this new future for the pharmacy profession. We all, however, need to build well and appeal broadly, just like Julius Caesar and Taylor Swift.

Ade Williams is a community pharmacist and contractor in Bristol